Savita Halappanavar: Bad Laws Kill

Bad laws kill.

Bad laws are dangerous. They have serious consequences for innocent people.

A case in point is the Irish law concerning abortion and the death of Savita Halappanavar.

I haven’t written anything about this tragedy because I couldn’t make sense of the press reports. I still can’t figure them out. There is mention of a septic e-coli infection, which so far as my limited medical knowledge goes, would probably be treated by antibiotics and fluids. Everyone seems to agree that Ms Halappanavar requested an abortion and was refused one by what sounds like medical personnel with the statement that “this is a Catholic country.” The other indisputable fact is that Ms Halappanavar died after what could only have been an agonizing period of suffering and lack of good medical care.

I don’t understand how an abortion might have helped her survive an e coli infection. I also don’t understand how she got an e coli infection or why it wasn’t treated appropriately. I’m not, mind you, making judgements here. These are questions for which I do not have answers.

The statement by the medical person that “this is a Catholic country” pulled the Catholic Church into the subsequent public debate about what happened to Ms Halappanavar. A lot of people who sincerely think that the Church hates women were quick to jump in and say “Told ya so!” Others spent a good bit of time trying to defend the Church with explanations that Catholic teaching does not forbid that women be given medical care, including treatment that can end a pregnancy, if the reason for doing so is to not for the direct purpose of killing the baby.

Theologians traded brickbats with outraged humanitarians and nobody understood anybody else. They weren’t speaking the same language and they have such a low opinion of one another that it precludes them trying to speak the same language.

Meanwhile, I kept circling back to the one thing I thought I understood about this tragedy: Somebody wrote a law that caused it.

Irish law isn’t like American law, so it’s hard for me to understand it or to know if I’ve gotten the right facts. I’ve spent some time reading the Irish Constitution, perusing Irish court cases, and checking statutes concerning abortion from centuries past. I still don’t really know for sure what it means, and I think that is the problem. I don’t think anyone knows what Irish law concerning abortion means.

The Irish Constitution makes a statement concerning abortion which reads more like a hatched up attempt to be theological than an honest try at creating a law that would lead to functional civil governance. It is more a statement of intent than anything else. I’ve been writing laws for 17 years, and I can tell you I don’t know how this thing is enforced or even what, exactly, it means.

The only part of it that actually is clear is the part that grants women the right to travel overseas to obtain an abortion and the right to give information about an abortion. Subsequent court cases have gone back and forth with these items until they’ve become convoluted in practice.

Here’s what the Irish Constitution says. I didn’t believe that this was all of Irish law on this matter at first, which is why I did the research. I’m going to set the worst part of it in bold face. Remember that the emphases are mine.

 

Ireland’s restriction on abortion is found in Article 40.3.3 of their Constitution. The latest amended version states:

The State acknowledges the right to life of the unborn and, with due regard to the equal right to life of the mother, guarantees in its laws to respect, and, as far as practicable, by its laws to defend and vindicate that right.

This subsection shall not limit freedom to travel between the State and another state.

This subsection shall not limit freedom to obtain or make available, in the State, subject to such conditions as may be laid down by law, information relating to services lawfully available in another state. Ir. Const., 1937, art 40.3.3

 

I don’t know if what I’m going to say will make sense to the people reading this, but that is not a law. It doesn’t say anything. Since it is in the Irish Constitution, I had assumed that there were further statutes that made sense of it. But I couldn’t find them and neither could the people who helped me research this. Read that paragraph I put in bold carefully. Does it tell anyone in the medical profession what they may or may not do?

There may be (hopefully there are) legal definitions of the terms this statement uses in other places in Irish law. There may be (hopefully there are) codifications and further statutes making sense of this. All I know is that when I researched Irish abortion law and case law about giving information about abortion and going to other states to obtain an abortion, this is what I was given.

How, based on this, is a doctor supposed to know what they may or may not do under Irish law to save a pregnant woman’s life? For that matter, how will they know what they may do to save the baby’s life? It ties their hands with confusion in either instance.

How are doctors supposed to “respect” the “equal right to life” of both the baby and the mother? What, in legal terms and in medical terms does “respect” mean? For that matter, what do “right to life” and “vindicate” mean?

I’m not nit-picking. Laws are built with words and words have meanings. For laws to be enforceable, the definitions of their words must be public and agreed upon.

Unless there are further codifications I don’t know about, or these things are legal terms of art in Ireland, this law is meaningless. It’s a statement. It’s a little speech. It gives some sort of vague intent. But it has no meaning.

That makes it a set-up for selective prosecution. By that I mean that if this truly is all there is to it, this law puts the entire decision as to what is or is not acceptable medical practice in dire situations concerning a pregnant woman in the hands of the prosecutor. Since this law means pretty much what anybody reading it wants it to mean, prosecutors can use it to punish doctors or let them off, depending on whatever motivation the prosecutor might have.

I have no idea what, specifically, the medical person meant with the comment, “this is a Catholic country.” For all I know, it may be have been some sort of personal religious statement. Or, it may have meant something else.

But the law reads like Irish politicians bent too far in trying to put theology into statute. Theology is, by its nature, vague and hypothetical. Law must be, by it’s nature, definite and immediately applicable to real-world situations.

I have looked at the Catholic Church’s teachings on this and come to the conclusion that I can not write a law that incorporates Catholic teaching directly into the statute. A law which allows abortion to save the life of the mother has to say just that. I am perfectly willing to stand on that opinion in the face of what comes.

If someone wants to argue with me about it, my answer has been and will continue to be the same. Give me the language. If you can come up with the language, I’ll support it. But I can’t figure out how to write a law any other way than with direct and clear language that has universally understood meaning.

I am a determined advocate for the Church’s right to be the Church without government interference. But I also believe that laws are not theology and, while theology can and should inform good law, the two do not mix in a direct way.

What I mean by that is that I don’t plan to copy the Catechism directly into the statutes and I will not vote for bills that attempt to do so. A law that says “Thou shalt not kill” is a vague, unenforceable statute. Murder is a legal term with definitions, penalties and clear-cut understanding both by the courts and by law enforcement. My opinion that murder should be a crime punishable by law is clearly informed by “Thou shalt not kill,” but you won’t see me putting those words into statute.

We can not write statutes concerning abortion any less carefully than we write any other statute. There is no place in law for statements of intent that are not followed by clear-cut statutory language afterwards. I thought at first that since this is the Irish Constitution there might be statutory language out there amplifying it. There may be such language, but I couldn’t find it. All I found was case law.

I’m going to close down this little discussion of the legal situation that I think led to the tragic death of Savita Halappanavar with a strong caveat. I went through what was available to me concerning Irish law on abortion. I also had expert help in my search. But Ireland is another country and I am not familiar with how they do things. What I’m trying to say is, I may be wrong. There may be better laws out there in Ireland that I didn’t find. If I am wrong, just tell me, and I’ll re-write this.

However, I do feel that this tragic death is a problem with Irish law in some way. Bad laws kill people. Writing a good law can take courage. I am overstepping and I know it when I say this, but I think Irish politicians need to re-think their laws concerning abortion. I am not advocating that they legalize abortion. Rather, I think they should write their laws in such a way that it’s possible for people to understand and follow them.

  • http://www.rosariesforlife.com Dave

    The problem with allowing “abortions to save the life of the mother” is that this is then up to the discretion of the doctor, and could become abortion on demand with just a “wink, wink.” I think it would need to be even more specific than that. Is there any actual case where an abortion would save the mother’s life anyway? Ron Paul stated that in his 20 years of obstetric practice and 50 years of knowledge of the field, he was not aware of any such case. I’ve heard other doctors say much the same.

    If you want to call the removal of an ectopic pregnancy an abortion, you could make a case for that, but I’m not aware of anything else.

    • Rebecca Hamilton

      One thing you will never see on this blog is a post from me saying that there is never a reason to stop a pregnancy to save the mother’s life. You won’t see it, because I don’t believe it’s true.
      I’ve passed laws with language from National Right to Life that allow abortion to save the mother’s life or if continuing the pregnancy will result in the permanent loss of a bodily function or organ. It was rather precise language and I’m not doing it justice here, due to my faulty memory. I think something like that is the way to go.
      As for doctors misusing this a statute that is framed like this, it might happen, but you can not write laws that won’t be violated. All you can do is your best. I know that sounds cavalier, and I don’t mean it that way. It’s a fact of life that has to be faced.

      • http://www.rosariesforlife.com Dave

        I don’t have a problem with that, but then again, if there ARE in fact cases where abortions needed to be performed to save the mother’s life, then it would be nice to hear what they are. Until then, I will agree with Ron Paul, the Association of Pro-Life Physicians, etc. that it is a myth.

        Also, I came across this referenced study:
        http://www.charismanews.com/us/34151-study-abortion-not-necessary-to-save-mothers-lives

        • Rebecca Hamilton

          One that I have knowledge of is an intra-uterine abscess. I had a friend who nearly died with this and the only way to treat it was to empty the uterus, which meant ending her pregnancy, (it was an early pregnancy, so there was no way to save the baby) as well. She was acutely ill and clearly dying before they did this and anti-biotics wouldn’t touch it because the uterus is sealed off. I’m sure there are other reasons, but this is one I have seen myself.

          I want to add that I see this argument as something akin to the pro choice people who argue that the baby is not a human being. I think it’s an avoidance to simplify what in truth is not always simple and avoid the moral implications of the simple fact that there are times in obstetrics when doctors have to make a choice to kill somebody. If they don’t decide, they kill both.

          This is what would have happened with the girl I knew. Without immediate medical intervention she would have been dead within a few hours. I have no doubt of that at all.

          I think the law needs to make allowance for these situations.

          • http://www.rosariesforlife.com Dave

            I guess I’ll have to take your word for it. It makes me sad if pro-life people lie (hopefully, they are really unaware) in order to make it seem cut-and-dry in all cases. Of course, if there are cases where surgery/treatment is urgently needed to save the life of the mother, and that treatment has the effect of ending the life of the child, then there is no problem with that morally.

            • Sus

              Rebecca, thank you for researching this with your “law maker” hat on. From what I’ve read, it does seem like the hospital and doctors are confused on how the law reads and what actions are allowed.

              Statistically speaking, abortion to save the life of the mother is minuscule compared to abortions that are done for all the many other reasons for abortion. The Pro-Life movement is wrong to focus attention on these kinds of abortions. It’s so volatile in many ways. It’s really hard for me to say that a mom that already has kids should sacrifice her life for an unborn baby. I think that situation is so personal that it isn’t for me or anyone else outside the family and doctors to say what should happen.

              Ireland definitely needs to make it clear on what doctors can and can’t do so this situation doesn’t happen again. Again, I don’t think the pro-life or pro-choice movements should be using this case to further their agenda. We have no idea what Savita felt about the politics of abortion. I don’t think it’s fair to use her now.

            • Rebecca Hamilton

              I spoke too harshly. I don’t think people are deliberately lying. They are just unaware and desiring to be persuaded. I would guess that Ron Paul (who appears to be that rarest of all things: an honest and open politician) just never encountered these things in his practice.

              I do believe that good prenatal care, proper diet, rest and a supportive family can either eliminate most reasons why women get to the point of death during pregnancy or treat them effectively enough that both the mother and the baby can come out of it alright. But the fact is that there are a lot of women who don’t see a doctor until they show up at the emergency room to deliver or when they get into big trouble. There are also a lot of women who work at very hard physical jobs while pregnant that, combined with bad diets, lack of medical care and life-long mistreatment, make them almost certain to have complicated, dangerous pregnancies.

              There are other women who simply abuse themselves with drugs, living on the street or some other thing.

              Also, accidents, deliberate violence, etc, can turn a routine pregnancy into a life-threatening emergency.

              I’m just talking off the top of my head here. If I did an exhaustive study, I’m sure I could come up with even more examples of why these things happen. The point is that lawmakers have to write laws that work for the whole population. That’s why I feel so strongly about this, you know. I write and vote on actual laws, and I don’t want to kill anybody with one of my decisions. I hold literally millions of lives in my hand at my job, and this responsibility goes on after I leave office to people who aren’t even born yet. It’s personal to me for that reason.

              • Melia

                Just out of interest, how do you reconcile this view with the Catholic teaching that does not allow abortion even when the mother’s life is at risk, and what would be your personal response to those kind of situations? This is not a condemnation – I’m just curious.

                • Rebecca Hamilton

                  As I understand it, (remember, I am not a theologian) the Church does not allow a deliberate abortion for the purpose of abortion. However, also as I understand it, if a necessary, life-saving, procedure causes a miscarriage or loss of the baby as a side effect, it can be allowed. For instance, removing a cancerous uterus that was also pregnant would not be a direct abortion. Neither would removing an ectopic pregnancy. I think it’s the same with draining an abscessed uterus. It’s a fine point, but I think that what I’m thinking falls within it. I’ve talked to my pastor about this several times in a lot more depth than I can go into here, but this is where I get this idea. I am concerned about this, not from a legalistic or even theological standpoint, but simply from the viewpoint that both the baby and the mother are people and I’ve been trying to figure out how to handle these rare but hard cases in a way that does justice to both lives and tries as much as possible to save them both, and, failing that, to not let them both die needlessly. It’s a tough, tough question and I don’t pretend to have it nailed down. I’m still thinking and praying and thinking some more.

                  • Eric D Red

                    Your ectopic pregnancy example is wrong, though, and a frequent example. And also a great example of how this approach fails.

                    It’s not acceptable to remove an ectopic pregnancy, as that would be an abortion, as the intent is to remove the fetus. However, it would be acceptable to remove the falopian tube completely, as the intent is then to remove the tube and the fetus a secondary effect. This is where this kind of mental gymnastics causes real problems. Either way, the fetus is dead, and it would have been anyway. However, in removing the whole falopian tube fertility is reduced. There is nothing gained, and something lost.

                    • Rebecca Hamilton

                      I checked here and it appears you are correct. However, I would never try to write a law that micro-manages medical practice to this extent. First, I don’t think it’s feasible, and secondly, I think it would result in the same type of paralyzing confusion I have talked about with the Irish law. I honestly don’t think it’s either advisable or even possible to legislate theology in the way that some of the commenters here seem to think should be done.

                    • Dave

                      I think it’s clear that matters such as ectopic pregnancy are still under discussion and that the Magisterium has not definitively ruled on them. Given a dilemma between two people dying rather than one person being saved and the other dying sooner, I think the choice is clear.

                      For example, if one person is trying to save another from drowning, but it is clear that the person one is trying to save is not going to make it and furthermore is going to pull you down too if you don’t get clear of them, it seems that it would not be a moral problem to cut them loose from your rope. To me, it seems that ectopic pregnancy is very much like that. In that case, even to remove the pregnancy, not the tube, could be permissible in my opinion, because the INTENT is not to kill the small human being, even though the RESULT will certainly be death.

                      I am no theologian, though, and I submit my judgment to that of the Magisterium.

                • Ted Seeber

                  Can we debate the actual teaching instead of what the New York Times thinks the Church Teaches?

                  2270 Human life must be respected and protected absolutely from the moment of conception. From the first moment of his existence, a human being must be recognized as having the rights of a person – among which is the inviolable right of every innocent being to life.72

                  Before I formed you in the womb I knew you, and before you were born I consecrated you.73
                  My frame was not hidden from you, when I was being made in secret, intricately wrought in the depths of the earth.74

                  2271 Since the first century the Church has affirmed the moral evil of every procured abortion. This teaching has not changed and remains unchangeable. Direct abortion, that is to say, abortion willed either as an end or a means, is gravely contrary to the moral law:

                  You shall not kill the embryo by abortion and shall not cause the newborn to perish.75
                  God, the Lord of life, has entrusted to men the noble mission of safeguarding life, and men must carry it out in a manner worthy of themselves. Life must be protected with the utmost care from the moment of conception: abortion and infanticide are abominable crimes.76

                  2272 Formal cooperation in an abortion constitutes a grave offense. The Church attaches the canonical penalty of excommunication to this crime against human life. “A person who procures a completed abortion incurs excommunication latae sententiae,”77 “by the very commission of the offense,”78 and subject to the conditions provided by Canon Law.79 The Church does not thereby intend to restrict the scope of mercy. Rather, she makes clear the gravity of the crime committed, the irreparable harm done to the innocent who is put to death, as well as to the parents and the whole of society.

                  2273 The inalienable right to life of every innocent human individual is a constitutive element of a civil society and its legislation:

                  “The inalienable rights of the person must be recognized and respected by civil society and the political authority. These human rights depend neither on single individuals nor on parents; nor do they represent a concession made by society and the state; they belong to human nature and are inherent in the person by virtue of the creative act from which the person took his origin. Among such fundamental rights one should mention in this regard every human being’s right to life and physical integrity from the moment of conception until death.”80

                  “The moment a positive law deprives a category of human beings of the protection which civil legislation ought to accord them, the state is denying the equality of all before the law. When the state does not place its power at the service of the rights of each citizen, and in particular of the more vulnerable, the very foundations of a state based on law are undermined. . . . As a consequence of the respect and protection which must be ensured for the unborn child from the moment of conception, the law must provide appropriate penal sanctions for every deliberate violation of the child’s rights.”81

                  2274 Since it must be treated from conception as a person, the embryo must be defended in its integrity, cared for, and healed, as far as possible, like any other human being.

                  Prenatal diagnosis is morally licit, “if it respects the life and integrity of the embryo and the human fetus and is directed toward its safe guarding or healing as an individual. . . . It is gravely opposed to the moral law when this is done with the thought of possibly inducing an abortion, depending upon the results: a diagnosis must not be the equivalent of a death sentence.”82

                  2275 “One must hold as licit procedures carried out on the human embryo which respect the life and integrity of the embryo and do not involve disproportionate risks for it, but are directed toward its healing the improvement of its condition of health, or its individual survival.”83

                  “It is immoral to produce human embryos intended for exploitation as disposable biological material.”84

                  “Certain attempts to influence chromosomic or genetic inheritance are not therapeutic but are aimed at producing human beings selected according to sex or other predetermined qualities. Such manipulations are contrary to the personal dignity of the human being and his integrity and identity”85 which are unique and unrepeatable

          • J. H. M. Ortiz

            Some misunderstanding of Catholic teaching on abortion comes, I think, from reading such statements as #45 of the USCCB’s Health Care Directives with insufficient attention to the words I emphasize here: “Abortion (that is, the DIRECTLY INTENDED termination of pregnancy before viability or the DIRECTLY INTENDED destruction of a viable fetus) is never permitted. Every procedure whose SOLE immediate effect is the termination of pregnancy before viability is an abortion, ….”
            In reality, then, the USCCB does NOT reckon it necessarily and always wrong to do a procedure which has an ADDITIONAL immediate effect besides terminating a pregnancy before viability — the effect, for instance, of removing some imminent life-threatening uterine condition.

  • http://coalitionforclarity.blogspot.com/ Robert King

    I haven’t studied law, but you raise an important point: that law should effective exactly as law.

    Off the top of my head, and not having studied law, it seems to me that a civil law should do at least one of three things:
    Define a term to be used in other laws
    Proscribe some action, which will face penalties if committed
    Prescribe some action, which will be rewarded if accomplished
    Am I in the ballpark here? Certainly, the piece of the Irish Constitution cited above does none of these things.

    • Rebecca Hamilton

      Yes, you’re in the ball park. Laws always in some way limit someone’s actions. Even if they grant actions to one party this means they take them from someone else. It is essential to define your terms and to set whatever penalties seem appropriate.

      Our Constitution here in America doesn’t create specific statutes. What happens here is that we have definitions of duties and limits of government in our Constitution. Then Congress and the states enact statutes that explicate those limits and privileges by acting on them. For instance, the government has the power to levy taxes. However, any tax would actually have to be created and enforced by statute in accordance with the powers specified in the Constitution.
      All I could find in Irish law was the Constitution, which is what makes this law so bad. However, even as a Constitutional proviso, I think it’s lacking because, as I say in the post, it says nothing. “Congress shall make no law establishing a religion or limiting the free exercise thereof.” is far more clear-cut than this statement in the Irish Constitution, which really doesn’t say anything.

  • Niemand

    I don’t understand how an abortion might have helped her survive an e coli infection.

    Infections can sometimes be treated with antibiotics and supportive care alone. However, when there is a nidus of infection such as dead or dying infected tissue, that source must be removed or the infection will continue. Halappanavar’s membranes had ruptured. The uterus is a sterile space, but the vagina is not. It contains bacteria, including, very commonly, E coli. And the colon-which is right there within easy cross contamination reach-always contains E coli. Antibiotics can not reach or completely sterilize a space so contaminated and only surgical intervention can cure it.

    Infection is a known and expected consequence of prolonged rupture of the membranes. That’s why women who have rupture of the membranes at or near term are delivered, one way or another, within 24 hours. Antibiotics can sometimes prevent the establishment of an infection and keep the pregnancy viable for a bit–but they’re useless against an established infection and they aren’t going to be able to keep the space sterile for the 2 months that would have been needed to get the fetus to anything resembling near enough to term for it to survive.

    Imagine if you had appendicitis. Appendicitis is just an infection of the appendix. Would you be happy if your doctor told you that you’d be treated with antibiotics only? Or would you be demanding surgery, as soon as possible? It’s the same problem: a source of infection to large and too poorly perfused by blood to be treated with antibiotics.

    But there’s worse here than the straight refusal to perform the abortion, which any competent OB/GYN would have done immediately and could legally be done under Ireland’s laws since the mother’s life was clearly in danger. There was, as you imply, also a failure to use appropriate supportive care. Dr. Halappanavar should have been treated aggressively with antibiotics and close monitoring from the first. She should have been in the ICU as soon as it was clear that she would not complete a spontaneous abortion. At least one source examining maternal mortality in Ireland found an unexpectedly large percentage of non-Irish women died in childbirth in Ireland. Perhaps it was not simply the doctors’ fear of being tried under Ireland’s abortion laws but also their prejudice against non-Irish that killed Dr. Halappanavar.

    I hope this is helpful to you in explaining the connection between an incomplete spontaneous abortion (also known as a miscarriage) and sepsis. The source of the infection is the dying or dead fetus and it is untreatable, except by removal. If this had been done as soon as it was clear that Halappanavar wasn’t going to deliver on her own and she’d been given presumptive antibiotics, she would have walked out of the hospital a few days later and possibly had a baby in a few years. Alas, the laws in Ireland and the choices her doctors made against her and her husband’s wills prevented those lives from ever occurring.

    • Rebecca Hamilton

      If her membranes had ruptured and she was in the process of miscarrying an already-dead baby, I don’t see the legal complications, even under this bad law. Again, I haven’t been able to make sense of this and I’m not a doctor so I don’t intend to have a lot of opinions about that angle of things. But nothing in the Irish law addresses the situation you describe, much less proscribes it. If you are correct, then what happened to this lady makes even less sense than I thought.
      I am assuming that medical practitioners in Ireland are intimidated by this vague law and the obvious threat of selective prosecution. I don’t know if that played a part in the decisions her physician made or if there were other factors.
      I’m not challenging you. I’m just curious. Do you have sources for your information that I could read? I’d just like to understand this better.

      • Niemand

        The problem is that the fetus still had a heartbeat. It was doomed-there was no way that it could be carried to viability-but not dead yet or at least not entirely dead (had a detectible heartbeat-which is not the medical definition of “alive”, but no one’s figured out how to stick EEG leads on a fetus). And I think you’re right that the vague law intimidated the doctors. A clearer law would at least give them something more to go on in making these decisions.

        I’m getting my information from Harrison’s Internal Medicine and Williams Obstetrics and Gynecology. In other words, medical texts that probably would be about as much fun for you to read as standard law texts would be for me. I’m not sure what a good general source for a description of treatment of infection with a surgical source would be…maybe PubMedPlus?

        • Rebecca Hamilton

          I’m still a little confused. Is your information concerning Ms Halappanavar’s medical situation coming from the popular press? If it is, then it’s no better than mine, which is to say insufficient to draw conclusions. As I said, what I’ve read is both sketchy and contradictory among the various sources. It reads like the authors are repeating things they’ve heard, many times from each other.

          • http://www.twitter.com/WCLPeter WCLPeter

            Before I begin my response I’d like to thank you for your clear and eloquent explanation of the lawmaking process, both in your original post and the answers you’ve provided above and below. This has been, in all honesty, one of the clearest explanations of this topic that I’ve read and it has given me a new level of understanding that I didn’t have before.

            While I’m certain the process of making laws is far more complicated than what you’ve outlined, I appreciated the opportunity to further my understanding of a topic I’d never really understood before.

            Thank you.

            I’m still a little confused.

            Your article, and some of your analysis, has caused me some confusion as well.

            I noted in your original post you had engaged in a great deal of research on the Abortion laws in Ireland, and even provided some cursory analysis – yet at the same time expressed confusion as to the details regarding the death of Mrs. Halappanavar.

            I’m confused by this because one of the very first links on Google, after typing her name, leads to the wikipedia page providing the details of her death. Not only does the page contain summaries of the events and reactions from various groups, it also provides links to the 51 references currently being used to compile this information. It also includes the links to a number of news organizations which had reported on her death. The open display of the various references allows for those so inclined to verify the validity of the summarized article.

            Once the inquests by the various government agencies and ethics review boards are completed I expect the page will be updated with not only their findings, but also the responses from the various groups those findings are sure to provoke.

            Yet, despite the presence of this article, and Niemand’s excellent explanations, you still seem to be quite skeptical as to the events surrounding her death:

            As I said, what I’ve read is both sketchy and contradictory among the various sources. It reads like the authors are repeating things they’ve heard, many times from each other.

            Contrast this statement with an article you wrote on November 24, 2012 regarding disturbing abortion practices in Canada. The source for that article was a single story with the sole reference of validity being links to the other sites discussing the story itself.

            In other words, the authors were repeating things they’d heard, many times from each other.

            When it was pointed out to you that there were serious doubts about the validity of the story referenced for your article, including links strongly indicating the referenced story was maliciously twisting an official medical term from a government website into a false and emotionally charged story, you continued to accept the referenced story and vehemently defended it as though it were unquestionably true.

            I don’t want to be rude, but you appear to be applying selective skepticism and willful ignorance to any opinions or information which contradicts your strongly held beliefs.

            • Rebecca Hamilton

              You are being rude, but no matter. I am not going to make medical judgements because I am not qualified to make medical judgements. No one has issued an authoritative medical opinion by qualified people who have all the facts for me to comment on what the true medical judgement in this case is. I’m not sure I will comment on it when they do, but whether or not I choose to do so is my decision.

              Wikipedia is a compendium of input from anonymous people. I sometimes link to it as a way of referencing something that I want people to see which is common knowledge, such as, say, the 10 Commandments. But I don’t consider it a final source on anything.

              As for the other article, I think that the people who are questioning it have an agenda. It never ceases to amaze me how vigorously pro abortion people will deny that babies are left to die when they survive abortions. I also think that a lot of the anger they dump on people who expose this horror is due to the challenge it makes to their own carefully maintained denial about what abortion is and what it does and what supporting it makes them.

    • Darren

      Thank you, Niemand, for a clear explanation of the medical challenge (likely) faced in this case.

      And thank you, Rebecca, for looking into the state of the Irish statutes, such as they are.

    • clare

      It is a questionable assertion that this woman would have lived if she had been allowed to have an abortion. She died of septicemia AND E.coli ESBL( this is antibiotic resistant and has caused a number of deaths in Europe). This provides a valid reason to question whether this woman would have survived, regardless of the treatment. The E.coli ESBL could have been the cause of the miscarriage in the first place and in itself can cause septicemia. It is quite possible that the medical removal (D & C) could have actually hastened her death. In the absence of medical reports we do not know what treatment the medics did or indeed the reasoning behind there actions. One thing is apparent many media outlets have totally underestimated the E Coli ESBL and the difficulty in treating it and some have actually omitted it completely . Far too many have prejudged this case with so few facts. Regarding the Law in relation to abortion in Ireland the government failed to legislate on foot of a referendum some 3o years ago but the Medical Council set down guidelines that doctors were to follow. The Medical Council guidelines state that abortion is illegal in Ireland except where there is a real and substantial risk to the mother’s life, as distinct from her health, and this risk includes possible suicide.
      The guidelines say in current obstetrical practice, rare complications can arise where therapeutic intervention, including termination, is required at a stage when due to the extreme immaturity of the baby, there may be little hope of the foetus surviving.
      “In these exceptional circumstances, it may be necessary to intervene to terminate the pregnancy to protect the life of the mother, while making every effort to preserve the life of the baby,” the Medical Council says.
      The Council guidelines also state that if a doctor has a conscientious objection to a course of action with a patient, he or she should explain this to the patient and make the names of other doctors available to them.
      “Conscientious objection does not absolve you from responsibility to a patient in emergency circumstances,” the guidelines state. There has never been any doctor prosecuted and most acknowledged that these guidelines were clear to them. Finally in relation to prejudice in this woman’s death there has never been any reported instances of such in our health care system. In Ireland we rely on staffing our hospitals with personnel from different parts of the world so many different nationalities work within our healthcare system. There has been a few non national maternity( amount to over 25% of births each year) deaths but at the same time there has been Irish women who have died also, there is no evidence that anybody group were treated any different.

      • Rebecca Hamilton

        Thank you for this information. What I read is that the question of suicide came about due to a court decision. If that is true, then it appears that the Council incorporated this into their guidelines.

        One thing I do not understand is how Medical Council guidelines operate in Ireland. Is the Medical Council considered a law-making body? Are Medical Council guidelines the same as statutes and considered enforceable law in Ireland? Are there penalties for noncompliance? This is not true of professional guidelines here in the United States, although they may be considered as part of a cause of action in a civil suit, but even there the basic cause of action must be statutory, as well.

        Also, in the situation we are discussing, we have a dead patient who might be alive with proper medical care. The maternity-related death of an otherwise healthy young woman (I am assuming that this lady was otherwise healthy) raises serious questions about medical practice.

        I still think the law concerning abortion in Ireland is a set-up for trouble because of its many complications. However, if the law is not at fault, then the question of medical malpractice needs to be looked at carefully. It’s possible that no malpractice exists. Also, I know nothing about Irish law in this regard. I’m speaking from American standards.

        • clare

          The Irish Medical Council is a Legal Body which all doctors practicing medicine must be a member of. All doctors must comply with their guidelines and a member of the public can make a complaint if they have concerns regarding any doctor. They have the power to remove them from their post and prevent them from practicing if they are found in breach of their guidelines. There have been terminations carried out here in the last 30 years where the life of the mother was deemed to be at risk but in saying that legislation is required to provide further clearer clarification. There was one piece of information given by the hospital to the general public and that was the timeline of events as seen by them.
          Sunday 21 October:
          Patient presents to hospital complaining of back pain.
          Patient is admitted with a threatened miscarriage to the Obstetrics and Gynaecology Unit.
          Monday 22 October:
          After 24 hours of admission, antibiotics are given.
          Tuesday 23 October:
          Patient transferred to theatre.
          Spontaneous miscarriage occurs.
          Wednesday 24 October:
          Post-theatre patient is transferred to Intensive Care Unit.
          Patient remains unwell.
          Thursday-Saturday 25-27 October:
          Patient continues to deteriorate.
          Sunday 28 October:
          Patient dies in ICU.
          This version is a little different in terms of timeline to what was reported in the newspaper article that broke the story. The ongoing inquiry will be important in establishing all the facts and indeed its findings may be medical malpractice , misjudgment of calculating the risk to the mother but it is impossible either way to say with any degree of certainty without all the facts.

          • Rebecca Hamilton

            It sounds as if the Irish Medical Council is at least somewhat analogous to the American Medical Association and the Bar Association. Both of them have the power to revoke professional licenses. However, neither of them are law-making bodies. There is a vast difference between the censure of a professional association and the power of a duly elected law-making body. There is also a vast difference between professional codes and criminal and civil statutes, as well as Constitutional mandates.

  • MARY LEWIS

    The main portion of law on abortion in Ireland is contained in sections 58 and 59 of the Offences against the Person Act 1861 which essentially makes it a criminal act to perform or procure an abortion. The Irish constitution simply has added a gloss to that law by way of the various amendments. It is important to be aware of this in order to fully understand the legal position. It is also of paramount importance to be aware of the excellent maternal mortality statistics relating to Ireland which are vastly superior to either the US or the UK. Finally the full facts of this case have yet to be published and many of the facts we have to date have emanated from those who wish to see Ireland have liberal abortion laws. It would be disastrous if this unfortunate and tragic case led to Ireland legislating for abortion in a manner similar to the UK or the US.

    • Rebecca Hamilton

      I saw this statute, my understanding is that current statutes supersede it. They certainly conflict with it.

      I agree with you about this tragedy being used for political purposes.

      • MARY LEWIS

        In both the Republic of Ireland and Northern Ireland (which is the only part of the UK not to have a liberal abortion regime) the 1861 Act is the main statute affecting abortion. It has not been superseded. In fact in the rest of the UK I believe it remains on the statute book, albeit the Abortion Act 1967 makes numerous exceptions to it.

        • Rebecca Hamilton

          I’ll check this further. In the United States, new law supersedes old law whenever there’s a conflict. Also, in the United States, Constitutional law always supersedes any statute. The 1861 statute seems to me to clearly conflicts with the Irish Constitution which is both newer and Constitutional.

          I have just gone over this with legal experts and what they say is that it seems that the 1861 statute is still in effect in Ireland, even though the Republic of Ireland separated from them. This scrambles things considerably. I found case law which says ““the court’s duty to defend and vindicate the right to life of the unborn was imposed by the clear rule of law of Article 40, s. 3, sub-s. 3 of the Constitution, notwithstanding that no law had yet been passed by the Oireachtas [Ireland’s legislature] in implementation of that provision.” Attorney General v. X, (1992) S.C. 846P (Ir.)”

          What I think that means is that the Constitutional language of 1992 which I referenced in this post is in effect, but that there have been no statutes making sense of it. In the United States, a Constitutional provision which conflicted with a statute would automatically make the statute unenforceable. Do statutes supersede Constitutional law in Ireland? Also, does old law supersede new law? That would be the reverse of the way we do it in the USA, but it may be so.

          Even though all this complicates things more than what I wrote, I think my basic contention that Irish law concerning abortion is inexplicable still stands. The 1861 statute penalizes both the woman who seeks an abortion and anyone who performs or helps to perform one rather severely and from what I’ve read. I do not see any exceptions to this law.

          Here’s part of the 1861 statute:
          58 Administering drugs or using instruments to procure abortion. .
          Every woman, being with child, who, with intent to procure her own miscarriage, shall unlawfully administer to herself any poison or other noxious thing, or shall unlawfully use any instrument or other means whatsoever with the like intent, and whosoever, with intent to procure the miscarriage of any woman, whether she be or be not with child, shall unlawfully administer to her or cause to be taken by her any poison or other noxious thing, or shall unlawfully use any instrument or other means whatsoever with the like intent, shall be guilty of felony, and being convicted thereof shall be liable . . . to be kept in penal servitude for life . . .
          59 Procuring drugs, &c. to cause abortion. .
          Whosoever shall unlawfully supply or procure any poison or other noxious thing, or any instrument or thing whatsoever, knowing that the same is intended to be unlawfully used or employed with intent to procure the miscarriage of any woman, whether she be or be not with child, shall be guilty of a misdemeanor, and being convicted thereof shall be liable . . . to be kept in penal servitude . . .”

          Based on this morass of conflicting statutes, I still think that Irish law concerning abortion is too much of a mess for doctors to have any idea what they may or may not do in emergency medical situations. I may be wrong, but that’s how it seems.

          • MARY LEWIS

            Rebecca The 1861 Act contains the law on the basic criminal law on the subject.The various amendments to the Irish constitution have been added in the last 30 years to clarify various positions. The first one in relation to the ban on abortion and the equal right of mother and child was inserted in 1983 to ensure that the criminal law was backed up by the Constitution. Subsequent amendments were inserted on the right to travel and the right to information. In spite of a number of high profile cases – ie the “X” case on suicide and the ECHR case of A, B and C, the practical outworkings of the law have generally not posed daily conundrums for medical practitioners .
            The alleged statement by a medical practitioner relating to “this is a Catholic country” has yet to be investigated. It may or may not have been said or if said, context is everything, in particular who may have said it.
            There has been a media frenzy over this sad event. The very fact that it has stunned so many of us may be answered by the fact that it is a very unusual event in Ireland. Women are not routinely dying because of bad law in Ireland. Is it a coincidence that the story which has generated global headlines was written by a journalist with strong family connections to two of the leading campaigners for abortion on the island of Ireland over the last thirty years?
            Careful note should be taken of the comments on infection by Clare. If e-coli ESBL was a factor then it is may well be that nothing would have saved the life of this poor woman and certainly not a change in the law.

  • Pingback: Savita Halappanavar: Bad Laws Kill | cathlick.com

  • Ted Seeber

    What I see missing is a right to medical conscience and a right to triage.

    That may well be elsewhere in Irish Law. I sincerely hope it is.

    But I can’t see the decisions of the doctors in this case being justified by EITHER “This is a Catholic Country” or that paragraph from the Irish Constitution. At all.

    • Rebecca Hamilton

      It seems those things are missing, but there’s a lot more wrong with these laws than that.

  • Bill S

    All I can say is that I’m glad that I don’t live in a Catholic country if something like this could happen in Ireland. That had to be a terribly insensitive thing to say. I can see why non-Catholics in Ireland might not care for their Catholic neighbors.

    Thankfully, we live in a country that does not let the Catholic Church have any say in the operation of its government. Our laws are free of religious influence.

    • Ted Seeber

      Our laws are free of all morality whatsoever, near as I can tell. That is only a good thing to a New Atheist who doesn’t understand the meaning of the words good and evil to begin with.

      • Bill S

        I think that some people are fixated on good v. evil. There are so many more appropriate adjectives to use: effective v. ineffective, helpful v. hurtful, fair v. unfair, etc. It is sad to see people spending their energies on this great battle of good v. evil, as if that is all we have to worry about. It was especially apparent in the election. These were just two men doing the best they could. One wasn’t good and the other evil. But that’s the way you seem to see everything.

        • Ted Seeber

          “I think that some people are fixated on good v. evil.”

          I will certainly admit to that.

          “There are so many more appropriate adjectives to use: effective v. ineffective, helpful v. hurtful, fair v. unfair, etc. ”

          I used to consider those more appropriate. I stopped when I realized that they were all words used to justify eugenics and racism.

          ” It is sad to see people spending their energies on this great battle of good v. evil, as if that is all we have to worry about. It was especially apparent in the election. These were just two men doing the best they could. One wasn’t good and the other evil. But that’s the way you seem to see everything.”

          I actually voted 3rd party because I saw them both as being evil.

          • Bill S

            That is a form of mental paralysis not being able to choose between two viable candidates. Given everything I have learned about you, I don’t understand why you would not have chosen Romney over Obama? What good did your vote do?

            Ted, for your sake, I would hope that you would learn to not see so many things as evil. How can you enjoy life when you see nothing but pitfalls? Do you think perhaps that your strict adherence to your faith is skewing your vision of reality? I don’t mean to criticize your beliefs, but anything to an extreme is not healthy.

            What do you see when you watch the nightly news? Do you see the whole world going to hell? Do you take the good news with the bad, or is it all bad to you? As far as this news story, how would you have liked to see it reversed and see the mother saved at the expense of the child, who died anyway? What if they had done the right thing and terminated the pregnancy to save her? What would you think of the doctors? Would you think they should be prosecuted under Irish Law?

            You leave me with so many questions. I’m interested in learning what makes you tick.

            • Ted Seeber

              I live in Oregon. My individual vote was going to do nobody any good whatsoever. Our state is split among the urban/rural divide with 65% Democratic- so overwhelming that the only thing Republicans can win is local elections. I couldn’t vote for Obama because of his libertine attitude towards sex, and I couldn’t vote for Romney because of his libertine attitude towards economics.

              This is in keeping with what I do as a Knight- my young council is extremely involved in corporal works of mercy for unwed mothers, their children, and the homeless.

              I have largely stopped watching the nightly news. There’s no good news to be had there. When I do, it’s only for the weather and traffic reports, and even then, it’s not ever any good news for somebody like me, with migraine induced photopobia and the several months of rain every year in this area of the country.

              As far as this news story- I would have liked to see the doctors attempt an immediate C-section, complete with incubator for the child and aggressive treatment of the infection for the mother. Wouldn’t have worked- our artificial wombs aren’t good enough yet. We aren’t even really that good at treating antibiotic-resistant E-coli at this stage, the outcome would have likely been the same. But a good pro-life doctor would have TRIED.

              • reader

                An immediate C-section would have greatly increased the risk of even more infections.

                Cutting apart the patient to save part of her body (the fetus) from the rest of her is not good medical care.

                • Rebecca Hamilton

                  If they baby was dead or she was in the process of miscarrying, then it would not have been abortion. I agree: a c-section sounds as if it would have been poor medicine in this case. However, everything I’m saying is conjecture since I don’t know the exact details of the medical situation.

  • MARY LEWIS

    Rebecca last week I left a number of comments on your article about the recent death of Mrs Savita Happanavar. You will recall that I urged that we all wait until further information was available before rushing to conclusions. I also indicated to you that the person who released the story was closely related to people promoting abortion in Ireland. I urge you to read this blog entry which confirms that it was correct not to conclude immediately that it was necessarily “bad law” which killed this unfortunate woman. Under the heading “Irish abortion story begins to unravel” http://garvan.wordpress.com/ a rather different picture begins to emerge. Please let your readers see this.

    • Rebecca Hamilton

      Mary, I would like to run this piece, but I don’t have supporting links for it. The ones in the article don’t lead me to anything that supports the contentions of the article. I honestly still think that Ireland needs to clarify their laws on the topic of abortion. I understand that they are under so much pressure now that any tampering with the law might have terrible results, so they should probably leave it alone for a while. But it needs to be done. I still think this is a bad law. As for Ms Happanavar’s death, I’ve always maintained that the press I’ve read about it don’t add up. If she truly did not ask for an abortion, then that does throw the whole thing in the trash. But, while this blog is very well written, it doesn’t have supporting documentation.

  • reader

    “I don’t understand how an abortion might have helped her survive an e coli infection. I also don’t understand how she got an e coli infection or why it wasn’t treated appropriately. ”

    She got it through her dilated cervix while she was miscarrying. Treatment to speed up the miscarriage and get it over with would have let her cervix close afterwards instead of keeping it open.